2026-27 Visiting Professor Host Application

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* 1. Please complete the following information for your program.

Name of program

City

State

Chair/Division Chief (Must be ASPS member)

Chair's email address

Primary Contact for ASPS Communication

Telephone

Email

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* 2. Please rank the below Visiting Professors, with 1 being the VP you would most like to host.

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* 3. Please check all visit formats that would apply to your requested visit.

Resident Lecture

Discussion Group

Patient Evaluation

Patient Rounds

Cadaver Lab

Other (please specify)

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* 4. Resident Focus

Yes, the focus of the requested visit will be on residents at resident training programs.

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* 5. At this time, what format would you prefer for your visit? (This will not be your final decision and the format can be decided at a later date.)

In-Person

Virtual